The use of feeding tubes which extend directly into the stomachs of patients is often required when patients cannot swallow or when they have strictures in their esophagi which prevent food from entering into their stomachs. In situations of this type, it is common to perform surgical procedures such as a percutaneous endoscopic gastrostomy (PEG) on the patient. In this procedure (PEG) an opening is formed in the skin, fascia and stomach wall and a gastrostomy tube is installed in the opening to allow food and/or medication to be passed directly into the stomach, and also to allow fluids to be drained therefrom.
When there is a need for direct intestinal feeding, one surgical procedure is to first install the gastrostomy tube and inflate the stomach with air. Then a guide wire is passed through the gastrostomy tube into the stomach where it is grasped with grasping forceps and dragged into the small intestine. The jejunal tube is then passed over the guide wire into the small intestine. When the feeding tube is in place, the wire can be removed and the patient can be fed.
However, the placement of the guide wire is difficult because the stomach collapses due to the escape of air through the gastrostomy tube. The deflation of the stomach makes it difficult for the Endoscopist to find the pylorus and the opening to the small intestine.
Thus, there is a need for a method of placing the guide wire in the small intestine without the deflation of the stomach.
The present inventive procedure is to place the guide wire through the gastrostomy tube which has a plug through which only the guide wire can pass. The stomach is inflated with air which is substantially prevented from escaping through gastrostomy tube by the plug, and the guide wire is pulled through the plug for placement. When the wire is in place in the small intestine, the plug is removed from the gastrostomy tube and a feeding tube is then passed over the guide wire into the small intestine. When the tube is in place, the wire is removed and feeding can take place.
The plug may comprise a substantially cylindrical member having a longitudinal bore for receiving the guide wire in slidable communication with the bore.